Successful in utero treatment of chronic and massive fetomaternal hemorrhage with fetal hydrops

Abstract

Background: Massive fetomaternal hemorrhage is an uncommon cause of chronic fetal anemia. Without treatment, hydrops fetalis can occur and progress toward death. In some cases, an early diagnosis can improve the management.

Case: A patient was found to have a fetus with non-immune hydrops related to massive and early fetomaternal hemorrhage successfully treated with serial fetal intravascular transfusion. After the treatment, ultrasonographic signs of hydrops disappeared and the pregnancy resulted in a good fetal outcome. There was no need for neonatal transfusion. Neurological examination at 1 month post-natal was normal.

Conclusion: When massive fetomaternal hemorrhage is diagnosed early in the pregnancy, serial fetal intravascular transfusion may be an alternative to immediate delivery.